The American Diabetes Association’s newly released 2026 National Access and Affordability Survey paints a stark picture of what it costs to live with diabetes and obesity in the United States today. The findings highlight rising out of pocket insulin costs, growing expenses for diabetes technology and obesity medications, and the difficult choices many households are forced to make. For anyone following the debate over insulin affordability and access to diabetes care, this report underscores how urgently families need solutions.

The survey, conducted online in June and July 2026, gathered perspectives from a statistically significant pool of households in which at least one person is living with diabetes, obesity, or both. Respondents included American Diabetes Association (ADA) advocates and market research panel participants. Together, their experiences reveal what it means in practical terms when healthcare costs climb faster than people’s ability to pay.

One of the most striking findings is how expensive insulin remains for many households. According to the ADA’s survey, 46% of respondents reported spending more than $100 per month on insulin. For a considerable portion of the population, this is not a one time cost but a recurring, nonnegotiable expense. Insulin is a lifesaving medication for people with diabetes, and skipping it is not an option without serious health risks. 

Yet the data show that too many people feel compelled to take that risk. The ADA reports that 41% of surveyed individuals rationed, delayed, or skipped insulin or treatment due to cost at some point over the last year. This means nearly half of respondents encountered moments when financial pressure outweighed medical necessity. I found this detail especially sobering, because it translates directly into higher chances of complications, hospitalizations, and long term harm.

The survey also indicates that insulin costs are not simply high, they are rising. Two in three people using insulin said their out of pocket insulin costs increased compared with 2025. Families who may already have trimmed budgets, sought coupons, or changed pharmacies appear to be facing another year of cost escalation. This type of trend can make even well planned healthcare budgets unstable and can push people into difficult tradeoffs month after month.

Insulin is only one component of diabetes care. The survey shows that 45% of households spent more than $200 per month on overall diabetes care. This figure can include doctor visits, additional medications, supplies, lab work, and other essentials that allow individuals to manage the condition effectively. At that level of spending, diabetes care competes directly with rent, utilities, transportation, and other basic needs.

The use of diabetes technology adds another layer of cost for many households. Devices such as continuous glucose monitors and insulin pumps have transformed diabetes management for many people, but they also bring regular outlays. The ADA’s findings show that 69% of people using diabetes technology spent up to $200 per month out of pocket for that technology. The survey’s wording makes it clear that these are not isolated one time purchases but ongoing monthly expenses that can strain even moderate incomes.

Obesity care is part of this affordability story as well. Nearly 1 in 4 surveyed households reported spending $200 or more per month on obesity medications. For people living with both diabetes and obesity, these costs can stack on top of insulin, devices, and other healthcare needs. The survey suggests that for many families, managing chronic conditions requires a level of financial commitment comparable to another housing or car payment.

Lisa Murdock, the ADA’s chief advocacy officer, emphasized that these findings show the high cost of diabetes and obesity care is still a serious barrier. She stressed that no one should have to ration insulin or delay treatment because they cannot afford essential care. According to Murdock, Congress and state policymakers have clear opportunities to reduce these obstacles, and the ADA plans to keep advocating for policies that improve access and affordability.

One policy focus that emerges directly from the survey is federal action on insulin pricing. The findings arrive at a time when Congress is considering the bipartisan Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2026, known as S. 4189 in the Senate and H.R. 10227 in the House. The bill would limit out of pocket monthly insulin costs to no more than $35 for individuals with private or employer sponsored health insurance. This proposed cap aims to extend protections similar to those already implemented for some Medicare beneficiaries and in certain states, bringing more equitable relief to people with commercial coverage.

Murdock pointed out that even after meaningful progress at the federal level for Medicare and through laws enacted in 29 states and Washington, D.C., many individuals with private insurance remain exposed to substantial insulin costs. The survey’s data on rising expenses and widespread rationing illustrates this gap. In her view, the INSULIN Act represents an important step toward closing that divide by ensuring that the amount people pay at the pharmacy counter is more predictable and manageable.

The 2026 National Access and Affordability Survey also connects to broader polling on healthcare burdens. Earlier national polling released by the ADA in June found that 1 in 3 respondents had to cut back on groceries because of healthcare expenses. When that insight is paired with the new survey’s details on insulin, technology, and obesity medication spending, a consistent pattern emerges. Many households trade nutritional quality, financial security, or other essentials to pay for the medications and tools that keep them healthy.

The American Diabetes Association presents these findings as part of its longstanding mission to end diabetes and help people thrive. For more than eight decades, the organization has pursued research, education, and advocacy to prevent diabetes, improve treatment, and work toward a cure. The current survey serves as both a snapshot of the financial realities households face and a call to action for policymakers, insurers, and stakeholders across the healthcare system.

Alongside federal initiatives such as the INSULIN Act, the ADA encourages the public to stay informed, share personal experiences when it feels safe to do so, and support efforts that remove cost related barriers to care. The organization provides additional information about its work to improve healthcare access and affordability at diabetes.org, and offers details about the INSULIN Act along with tools to contact members of Congress at diabetes.org/InsulinAct. Read more at https://diabetes.org/newsroom/press-releases/american-diabetes-associations-2026-national-access-and-affordability